Surgical catgut embedding
Puncture needle implantation method: routinely sterilize local skin, clamp a sterilized catgut with a length of about 1 ~ 2cm, place it at the front end of the needle tube of lumbar puncture needle, then connect the needle core, tighten or lift the skin at the needle insertion site with the thumb and forefinger of the left hand, and hold the needle in the right hand to pierce to the required depth. When the needle feels, push the needle core while pulling out the needle tube, and bury the catgut into the subcutaneous tissue or muscle layer of the acupoint. You can also use the needle of No.9 injection needle as the cannula, cut the needle of No.28 2-inch long millineedle as the needle core, and put No.00 catgut 1 ~ 1.5 cm into the needle and bury it in the acupoint. The operation method is the same as before. When embedding thread with special embedding needle, after local skin disinfection, use 0.5 ~ 1% procaine hydrochloride as infiltration anesthesia, cut a length of catgut (about 1 cm), put it in the gap between the needle tips of embedding thread, clamp both ends with vascular forceps, hold the needle in the right hand and clamp it in the left hand, and the gap between the needle tips is downward15 ~.
Buried thread method of triangular needle: at both sides of acupoint 1 ~ 2 cm, gentian violet is used as the mark of entering and leaving the needle tip. After skin disinfection, use 0.5 ~ 1% procaine hydrochloride as intradermal anesthesia at the mark, use a needle holder to hold a skin suture needle with catgut, pierce it from a local anesthesia point, pass through subcutaneous tissue or muscle layer below acupuncture point, and pass through the contralateral local anesthesia point, clamp the skin between two pinholes and cut off the ends of catgut at both ends, relax the skin, and gently massage to make catgut completely buried in subcutaneous tissue.
3. Incision and catgut embedding method: use 0.5% procaine hydrochloride as infiltration anesthesia at selected acupoints, cut the skin with a knife tip (0.5 ~ 1cm), first probe the blood forceps into the depths of acupoints, massage through superficial fascia for a few seconds, find the pain point, rest for 1 ~ 2 minutes, and then use 0.5 ~ 65438+.
Acupoints with full muscles are often selected for catgut embedding, and waist and waist acupoints are the most commonly used. The principle of acupoint selection is the same as that of acupuncture therapy, but it should be simplified. Catgut embedding at point 1 ~ 3 every time can be treated every 2 ~ 4 weeks/time.
Contraindications
This method is not suitable for skin infection or ulcer, active tuberculosis, severe heart disease or pregnancy.
Matters needing attention
Strict aseptic operation to prevent infection, triangular needle embedding operation should be light and accurate to prevent needle breakage.
It is best to bury the thread between subcutaneous tissue and muscle, where the muscle is full, it can be buried in the muscle layer, and the catgut thread should not be exposed outside the skin.
According to different parts, master the depth of embedding thread, so as not to hurt internal organs, large blood vessels and nerve trunks, so as not to cause dysfunction and pain.
After the catgut is used, it can be soaked in 75% Chinese liquor, or treated with bromogeramine, and then soaked in normal saline.
When multiple treatments are carried out on an acupoint, the site of the previous treatment should be deviated.
Pay attention to the postoperative reaction. One is normal reaction. Due to stimulation injury and catgut stimulation, local aseptic inflammatory reactions such as redness, swelling, heat and pain occur within 1 ~ 5 days. In a few cases, the reaction is serious, and there is a small amount of exudate at the incision, which is also normal and generally does not need to be treated. If there are many exudates protruding from the skin surface, the milky exudate can be squeezed out, wiped off with 70% alcohol cotton ball and covered with sterile gauze. The local temperature of the affected limb will also increase after operation, which can last for 3 ~ 7 days. A few patients may have systemic reaction, that is, the body temperature rises within 4 ~ 24 hours after catgut embedding, generally around 38℃, and there is no local infection, and the body temperature returns to normal after 2 ~ 4 days. The total number of white blood cells and neutrophils may increase after catgut embedding, so pay attention to observation.
The other is abnormal reaction, which has the following situations:
A small number of patients are infected due to lax aseptic operation or poor wound protection during treatment. Generally, local redness and swelling appear 3 ~ 4 days after treatment, and the pain can be aggravated, which may be accompanied by fever. Local hot compress and anti-infection treatment should be carried out.
Some patients are allergic to catgut, and after treatment, local redness, itching, fever and other reactions will occur, and even fat liquefaction and catgut overflow at the incision will occur, so appropriate antiallergic treatment should be carried out.
Nerve damage. If the sensory nerve is injured, skin sensory disturbance will appear in the nerve distribution area. Motor nerve injury will lead to nerve-controlled muscle group paralysis. If the sciatic nerve and peroneal nerve are injured, it will cause the foot to droop and the big toe cannot bend backwards. When this happens, the catgut should be pulled out in time and properly handled.
Do double eyelids
principle
The principle of double eyelid catgut embedding method is that the upper eyelid skin adheres to the levator palpebrae aponeurosis or palpebral plate through suture and/or wound and inflammatory reaction caused by suture to form double eyelid.
indicate
The double eyelid catgut embedding method is suitable for those with large eyelid fissure, thin eyelid, no swelling, no slack upper eyelid skin and no obvious epicanthus.
Surgical technique
There are many surgical methods to bury double eyelids, such as intermittent suture or continuous suture, full-thickness suture or partial suture of upper eyelid, needle insertion from skin or conjunctiva, one or more stitches, suture removal or no suture removal, etc. It is worth mentioning that the method of double eyelid surgery through conjunctival approach has been basically eliminated, and the more commonly used method is continuous or intermittent catgut embedding through percutaneous approach. However, the continuous catgut embedding method requires relatively skilled operation technology and clinical experience, and experienced doctors should be the first choice.
Advantages of embedding double eyelids
Simple operation, easy to master, less trauma, quick recovery, no or no small incision, no obvious scar after operation, easy to repair once the appearance is not satisfactory, and easy to be accepted by the operator.
Disadvantages of embedding double eyelids
Double eyelids tend to become shallow and narrow, or even disappear; Suture knot buried too shallow, easy to expose or form small cysts; If the suture position is too high, it limits the activity of levator palpebrae superioris and Miller muscle, which may lead to ptosis, eye fatigue and difficulty in opening eyes. Loose skin and orbital fat cannot be removed.
Related reminders
The curative effect of catgut embedding is best in the muscle layer, such as in the thin parts of the head, face, limbs and other muscles, which can be buried between the subcutaneous tissue and the muscle layer, and the muscle part can be buried in the muscle layer, and the catgut can not be exposed to the skin. According to different parts, the embedding needle is disposable and sterilized by ethylene oxide. Sterilization is valid for two years. The package is damaged, so it is forbidden to use.
Disposable use means that a patient uses one acupoint for different acupoints. It should not be used for the second patient to prevent cross infection.
According to the theory of acupuncture, acupuncture plus medicated thread can stimulate meridians, balance yin and yang, harmonize qi and blood, and adjust viscera, thus achieving the purpose of treating diseases.